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Ruegg L, Vonzun L, Latal B, Moehrlen U, Mazzone L, Meuli M, Krähenmann F, Ochsenbein-Kölble N. Impact on postoperative, neonatal and 2-year neurodevelopmental outcomes of UA-AREDF during and after fetal spina bifida repair. Ultrasound Obstet Gynecol 2023; 61:734-739. [PMID: 36357943 DOI: 10.1002/uog.26118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/07/2022] [Accepted: 10/18/2022] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Absent or reversed end-diastolic flow (AREDF) in the umbilical artery (UA) on Doppler is a known phenomenon during fetal interventions, such as fetal open spina bifida (OSB) repair. We aimed to evaluate the clinical importance of these Doppler findings by investigating the impact of UA-AREDF on postoperative, neonatal and 2-year neurodevelopmental outcomes. METHODS This was a prospective study of pregnancies undergoing fetal OSB repair at the Zurich Center for Fetal Diagnosis and Therapy between 2010 and 2019. The group with UA-AREDF during or immediately after the intervention was compared to the group with normal UA Doppler. Primary endpoint was the FIGO scores of cardiotocography (CTG) 1, 2 and 6 h postoperatively and on day 1 after surgery. Secondary endpoints were the neonatal parameters and 2-year neurodevelopmental outcome assessed using the Bayley Scales of Infant and Toddler Development, Third Edition. RESULTS Data of 130 patients were analyzed. None of the fetuses had UA-AREDF before OSB repair. Normal UA Doppler was observed in 107 (82%) patients and UA-AREDF was observed in 23 (18%) during or immediately after OSB surgery. UA-AREDF was more often observed after version of the fetus (P = 0.045). Seventeen (13%) cases had absent end-diastolic flow (UA-AEDF) and six (5%) cases had reversed end-diastolic flow (UA-REDF). UA-AREDF disappeared in all 23 cases within the first day after OSB surgery. One-third of all CTGs were restricted in oscillation after surgery, but no significant difference in CTG 1, 2 and 6 h postoperatively or on the first postoperative day was found between the UA-AREDF and normal-Doppler groups (P > 0.05). Gestational age at delivery, UA pH, 5-min Apgar score and birth weight were comparable between the two groups, and there was no difference in the 2-year neurodevelopmental outcome (P > 0.05). The neonatal and 2-year neurodevelopmental outcomes also did not differ significantly between the UA-REDF and UA-AEDF groups. CONCLUSIONS Postoperative CTG abnormalities occur and recover at a similar rate in fetuses with transitory UA-AREDF and those with normal Doppler during fetal OSB repair. UA-AREDF during fetal OSB repair did not negatively influence postnatal or 2-year neurodevelopmental outcomes. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- L Ruegg
- Department of Obstetrics, University Hospital of Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - L Vonzun
- Department of Obstetrics, University Hospital of Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- Zurich Center for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
| | - B Latal
- University of Zurich, Zurich, Switzerland
- Department of Neuropediatrics, University Children's Hospital Zurich, Zurich, Switzerland
- Spina Bifida Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - U Moehrlen
- University of Zurich, Zurich, Switzerland
- Zurich Center for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
- Spina Bifida Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - L Mazzone
- University of Zurich, Zurich, Switzerland
- Zurich Center for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
- Spina Bifida Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - M Meuli
- University of Zurich, Zurich, Switzerland
- Zurich Center for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
- Spina Bifida Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - F Krähenmann
- Department of Obstetrics, University Hospital of Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- Zurich Center for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
| | - N Ochsenbein-Kölble
- Department of Obstetrics, University Hospital of Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- Zurich Center for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
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Voci A, Bruni O, Ferilli M, Papetti L, Tarantino S, Ursitti F, Sforza G, Vigevano F, Mazzone L, Valeriani M, Moavero R. Sleep Disorders in Pediatric Migraine: a questionnaire-based study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Moavero R, Voci A, Romigi A, Bisulli F, Luisi C, Vigevano F, Mazzone L, Valeriani M, Curatolo P, Bruni O. Sleep disorders in adults with tuberous sclerosis complex: a questionnaire-based study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tra S, Ochsenbein-Kölble N, Stein P, Meuli M, Moehrlen U, Mazzone L, Kraehenmann F, Zimmermann R, Biro P. Association of uterine activity and maternal volatile anesthetic exposure during open fetal surgery for spina bifida: a retrospective analysis. Int J Obstet Anesth 2021; 46:102974. [PMID: 33780714 DOI: 10.1016/j.ijoa.2021.102974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/22/2020] [Accepted: 02/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recent warnings postulate a possible damaging effect of volatile anesthetics on the fetus. In our archive of fetal surgeries, we found wide variation in dosing of volatile anesthetics during spina bifida surgeries. We hypothesized that there was an association between volatile anesthetic exposure and uterine activity. METHODS Sixty anesthesia records from spina bifida operations were assessed. We analyzed the course of the administered volatile anesthetic during surgery and calculated from each patient's anesthesia record the volatile anesthetic exposure expressed in vol%h. We divided the records into two post hoc groups of the 20 lowest exposure (Group L) versus the 20 highest exposure (Group H), and compared them for uterine activity and fetal heart rate. RESULTS The number of contractions per hour was significantly greater in Group H (mean 1.3, SD ± 1.2) compared with Group L (mean 0.5, SD ± 0.6, P=0.049). There was no difference between the groups for the administration of the tocolytic drug atosiban (P=0.29). The course of the mean arterial pressure did not significantly differ but group H needed significantly more vasoactive medication (P <0.05). CONCLUSIONS We found that a lower intra-operative volatile anesthetic exposure than recommended in the MOMS-trial (i.e. <2.0 minimum alveolar concentration [MAC]) was not associated with an increase in intra-operative uterine activity. This is an indication that during spina bifida surgery, 2.0 MAC may not be necessary to avoid potentially harmful uterine activity.
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Affiliation(s)
- S Tra
- Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland.
| | - N Ochsenbein-Kölble
- Department of Obstetrics, University Hospital Zurich, Zurich, Switzerland; The Zurich Center for Fetal Diagnosis and Therapy, Zurich, Switzerland
| | - P Stein
- Institute of Anesthesiology, Emergency Medical Service, Perioperative Medicine, Pain Therapy, Cantonal Hospital Winterthur, Switzerland
| | - M Meuli
- Department of Surgery, University Childrens' Hospital Zurich, Zurich, Switzerland; The Zurich Center for Fetal Diagnosis and Therapy, Zurich, Switzerland
| | - U Moehrlen
- Department of Surgery, University Childrens' Hospital Zurich, Zurich, Switzerland; The Zurich Center for Fetal Diagnosis and Therapy, Zurich, Switzerland
| | - L Mazzone
- Department of Surgery, University Childrens' Hospital Zurich, Zurich, Switzerland; The Zurich Center for Fetal Diagnosis and Therapy, Zurich, Switzerland
| | - F Kraehenmann
- Department of Obstetrics, University Hospital Zurich, Zurich, Switzerland; The Zurich Center for Fetal Diagnosis and Therapy, Zurich, Switzerland
| | - R Zimmermann
- Department of Obstetrics, University Hospital Zurich, Zurich, Switzerland; The Zurich Center for Fetal Diagnosis and Therapy, Zurich, Switzerland
| | - P Biro
- Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland; The Zurich Center for Fetal Diagnosis and Therapy, Zurich, Switzerland
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Vonzun L, Kahr MK, Noll F, Mazzone L, Moehrlen U, Meuli M, Hüsler M, Krähenmann F, Zimmermann R, Ochsenbein-Kölble N. Systematic classification of maternal and fetal intervention-related complications following open fetal myelomeningocele repair - results from a large prospective cohort. BJOG 2020; 128:1184-1191. [PMID: 33152167 DOI: 10.1111/1471-0528.16593] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To systematically categorise all maternal and fetal intervention-related complications after open fetal myelomeningocele (fMMC) repair of the first 124 cases operated at the Zurich Centre for Fetal Diagnosis and Therapy. DESIGN A prospective cohort study. SETTING Single centre. POPULATION Mothers and fetuses after fMMC repair. METHODS Between 2010 and 2019, we collected and entered all maternal complications following fMMC repair into the Clavien-Dindo classification. For fetal complications, a classification system based on the Medical Dictionary for Regulatory Activities terminology of Adverse Events was used including the preterm definitions of the World Health Organization. MAIN OUTCOME MEASURES Systematic classification of maternal and fetal complications following fMMC repair. RESULTS Gestational ages at surgery and birth were 25.0 ± 0.8 and 35.4 ± 2.0 weeks, respectively. In 17% of all cases, no maternal complications occurred. Maternal intervention-related complications were observed as follows: 69% grade 1, 36% grade 2, 25% grade 3, 6% grade 4 and 0% grade 5. In 34%, no fetal complications were noted; however, 43% of the fetuses developed a grade 1, 14% a grade 2, 8% a grade 3, 2% a grade 4 and 2% a grade 5 complication. CONCLUSION This study raises awareness of complications following open fMMC repair; 6% of mothers and 2% of fetuses experienced a severe complication (grade 4) and perinatal death rate of 2% was observed (grade 5). These data are useful for prenatal counselling, they help to improve the system of fetal surgical care, and they allow benchmarking with other centres as well as comparison with fetoscopic approaches. TWEETABLE ABSTRACT Systematic classification of all maternal and fetal intervention-related complications following open fMMC repair.
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Affiliation(s)
- L Vonzun
- Division of Obstetrics, University Hospital of Zurich, Zurich, Switzerland.,The Zurich Centre for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
| | - M K Kahr
- Division of Obstetrics, University Hospital of Zurich, Zurich, Switzerland
| | - F Noll
- Division of Obstetrics, University Hospital of Zurich, Zurich, Switzerland
| | - L Mazzone
- The Zurich Centre for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland.,Department of Paediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland.,Spina Bifida Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland
| | - U Moehrlen
- The Zurich Centre for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland.,Department of Paediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland.,Spina Bifida Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland
| | - M Meuli
- The Zurich Centre for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland.,Department of Paediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland.,Spina Bifida Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland
| | - M Hüsler
- Division of Obstetrics, University Hospital of Zurich, Zurich, Switzerland.,The Zurich Centre for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
| | - F Krähenmann
- Division of Obstetrics, University Hospital of Zurich, Zurich, Switzerland.,The Zurich Centre for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
| | - R Zimmermann
- Division of Obstetrics, University Hospital of Zurich, Zurich, Switzerland.,The Zurich Centre for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
| | - N Ochsenbein-Kölble
- Division of Obstetrics, University Hospital of Zurich, Zurich, Switzerland.,The Zurich Centre for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
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Vonzun L, Mazzone L, Moehrlen U, Meuli M, Krähenmann F, Zimmermann R, Ochsenbein-Kölble N, Horst M. Systematic sonographic bladder volume measurements at evaluation and directly after fetal myelomeningocele repair – is bladder function predictable? Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- L Vonzun
- Universität Zürich, Klinik für Geburtshilfe
- Zurich Center for Fetal Diagnosis and Therapy, Univeristy of Zurich
| | - L Mazzone
- Zurich Center for Fetal Diagnosis and Therapy, Univeristy of Zurich
- Kinderspital Zürich, Chirurgische Klinik
- Spina Bifida Center, University Children’s Hospital
| | - U Moehrlen
- Zurich Center for Fetal Diagnosis and Therapy, Univeristy of Zurich
- Kinderspital Zürich, Chirurgische Klinik
- Spina Bifida Center, University Children’s Hospital
| | - M Meuli
- Zurich Center for Fetal Diagnosis and Therapy, Univeristy of Zurich
- Kinderspital Zürich, Chirurgische Klinik
- Spina Bifida Center, University Children’s Hospital
| | - F Krähenmann
- Universität Zürich, Klinik für Geburtshilfe
- Zurich Center for Fetal Diagnosis and Therapy, Univeristy of Zurich
| | - R Zimmermann
- Universität Zürich, Klinik für Geburtshilfe
- Zurich Center for Fetal Diagnosis and Therapy, Univeristy of Zurich
| | - N Ochsenbein-Kölble
- Universität Zürich, Klinik für Geburtshilfe
- Zurich Center for Fetal Diagnosis and Therapy, Univeristy of Zurich
| | - M Horst
- Kinderspital Zürich, Chirurgische Klinik
- Spina Bifida Center, University Children’s Hospital
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Zupan R, Meuli M, Möhrlen U, Mazzone L, Krähenmann F, Hüsler M, Zimmermann R, Ochsenbein-Kölble N. Reproductive outcomes after fetal myelomeningocele repair. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- R Zupan
- Klinik für Geburtshilfe, UniversitätsSpital Zürich
| | | | | | | | - F Krähenmann
- Klinik für Geburtshilfe, UniversitätsSpital Zürich
| | - M Hüsler
- Klinik für Geburtshilfe, UniversitätsSpital Zürich
| | - R Zimmermann
- Klinik für Geburtshilfe, UniversitätsSpital Zürich
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Kahr M, Meuli M, Moehrlen U, Mazzone L, Winder F, Vonzun L, Krähenmann F, Hüsler M, Zimmermann R, Ochsenbein-Kölble N. Open intrauterine fetal Myelomeningocele repair: Learning curve of the surgical procedure and perinatal complications. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- M Kahr
- Universitätsspital Zürich, Gynäkologie und Geburtshilfe, Zürich, Schweiz
| | - M Meuli
- Kinderspital Zürich, Zürich, Schweiz
| | | | - L Mazzone
- Kinderspital Zürich, Zürich, Schweiz
| | - F Winder
- Universitätsspital Zürich, Geburtshilfe, Zürich, Schweiz
| | - L Vonzun
- Universitätsspital Zürich, Geburtshilfe, Zürich, Schweiz
| | - F Krähenmann
- Universitätsspital Zürich, Geburtshilfe, Zürich, Schweiz
| | - M Hüsler
- Universitätsspital Zürich, Geburtshilfe, Zürich, Schweiz
| | - R Zimmermann
- Universitätsspital Zürich, Geburtshilfe, Zürich, Schweiz
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Vonzun L, Winder FM, Meuli M, Moerlen U, Mazzone L, Krähenmann F, Hüsler M, Zimmermann R, Ochsenbein-Kölble N. Hindbrain herniation, banana, and lemon sign after open fetal myelomeningocele repair – when do this signs disappear and is shunting predictable? Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- L Vonzun
- Department of Obstetrics, University of Zurich, Zürich, Schweiz
| | - FM Winder
- Department of Obstetrics, University of Zurich, Zürich, Schweiz
| | - M Meuli
- University Children's Hospital Zurich, Zürich, Schweiz
- Zurich Center for Fetal Diagnosis and Therapy, Department of Pediatric Surgery, Zürich, Schweiz
| | - U Moerlen
- University Children's Hospital Zurich, Zürich, Schweiz
- Zurich Center for Fetal Diagnosis and Therapy, Department of Pediatric Surgery, Zürich, Schweiz
| | - L Mazzone
- University Children's Hospital Zurich, Zürich, Schweiz
- Zurich Center for Fetal Diagnosis and Therapy, Department of Pediatric Surgery, Zürich, Schweiz
| | - F Krähenmann
- Department of Obstetrics, University of Zurich, Zürich, Schweiz
- Zurich Center for Fetal Diagnosis and Therapy, Department of Pediatric Surgery, Zürich, Schweiz
| | - M Hüsler
- Zurich Center for Fetal Diagnosis and Therapy, Department of Pediatric Surgery, Zürich, Schweiz
| | - R Zimmermann
- Department of Obstetrics, University of Zurich, Zürich, Schweiz
- Zurich Center for Fetal Diagnosis and Therapy, Department of Pediatric Surgery, Zürich, Schweiz
| | - N Ochsenbein-Kölble
- Department of Obstetrics, University of Zurich, Zürich, Schweiz
- Zurich Center for Fetal Diagnosis and Therapy, Department of Pediatric Surgery, Zürich, Schweiz
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Kahr M, Winder F, Vonzun L, Meuli M, Moehrlen U, Mazzone L, Krähenmann F, Hüsler M, Zimmermann R, Ochsenbein-Kölble N. Risk factors for preterm birth following open fetal myelomeningocele repair – results from a prospective cohort. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- M Kahr
- Universitätsspital Zürich, Geburtshilfe, Zürich, Schweiz
| | - F Winder
- Universitätsspital Zürich, Geburtshilfe, Zürich, Schweiz
| | - L Vonzun
- Universitätsspital Zürich, Geburtshilfe, Zürich, Schweiz
| | - M Meuli
- Kinderspital Zürich, Zürich, Schweiz
| | | | - L Mazzone
- Kinderspital Zürich, Zürich, Schweiz
| | - F Krähenmann
- Universitätsspital Zürich, Geburtshilfe, Zürich, Schweiz
| | - M Hüsler
- Universitätsspital Zürich, Geburtshilfe, Zürich, Schweiz
| | - R Zimmermann
- Universitätsspital Zürich, Geburtshilfe, Zürich, Schweiz
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Giovagnoli G, Mossolani G, Napoli E, Pontillo M, Vicari S, Mazzone L. Efficacy of romantic and sexual psycho-educational training for adolescent with high-functioning autism spectrum disorder: A pilot study. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionRomantic and sexual functioning in individuals with autism spectrum disorder (ASD) are understudied. Recent findings evidenced that adolescents and adults with present romantic and sexual behaviors comparable with their neurotypical peers. However, it is worth to note that dysfunctional and inappropriate romantic and sexual behaviors are often described in this population.ObjectivesTo investigate efficacy of a psycho-educational training in a small group of adolescent with high-functioning ASD (HFA, QI > 70).MethodsSix adolescents (all males, range age 14–16 years) have been evaluated before (T0) and after (T1) a 10-session sexual and romantic psycho-educational structured group training, of 90′ each session. Clinical evaluation included parent-report questionnaires, as SBS for sexual behaviors and CBCL for behavioral problems, and a self-report questionnaire for sexual behaviors, called SESAMO. Moreover, autistic symptoms were investigated with ADOS-2 at T0.ResultsPreliminary analysis revealed a statistically significant differences between T0 and T1 in sexual education (P = 0.02) and frequency of dysfunctional sexual behaviors (P = 0.02) of SBS and in sexual expectations about the partner in SESAMO (P = 0.04). No differences were found in CBCL.ConclusionPreliminary results showed an improvement of romantic and sexual functioning in adolescent boys with HFA, as reported by either parents and adolescents, after participating to a structured psycho-educational training. More sexual education and information, less inappropriate sexual behaviors and more-appropriate expectations about potential partner were reported at the end of the training. These results should be confirmed in studies including larger ASD and control sample.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Castaldo L, Mazzone L, Serra G, Vicari S. Risk Factors for Suicide Attempt: A Retrospective Study. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IntroductionSuicide is a leading cause of death among adolescents.ObjectivesTo investigate suicidal behaviors among Italian adolescents.AimsTo assess the rates of suicidal ideation (SI) and suicide attempts (SA) and the associated risk factors in patients admitted to emergency department (ED) of the Bambino Gesù Children's Hospital.MethodsRetrospective study based on data of patients admitted to the ED from 1 January 2011 to 30 May 2016 who required a neuropsychiatric (NPI) consultation. We analyzed:– outcome of the NPI consultation (hospitalization or discharge);– risk factors for SA and SI;– methods employed for SA.ResultsThe number of NPI consultations for SI and SA increased from 6.45% in 2011 to 13.3% in 2015. More than 90% of consultations recommended hospitalization in the psychiatric unit (137 patient [66% female]; mean age of 15.5 ± 1.6 years) with average length of stay of 13.64 ± 10.63 days. Risk factors for SI and SA were non-suicidal self-injury, family conflicts and previous suicide attempts. Subjects evaluated for a SA reported a significantly higher frequency of family history of mood disorder (χ2 = 5.94; P = 0.02) and a comorbid substance abuse (χ2 = 4.49; P = 0.03) when compared with SI group. The method most frequently used to attempt suicide was ingestion of medications (52.83%).ConclusionsThere was an increasing demand of NPI consultation of SA and SI in the last years. A family history of mood disorder and a history of substance abuse are risk factors able to differentiate between SI and SA.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Affiliation(s)
- L Mazzone
- Zurich Center for Fetal Therapy, University Children's Hospital Zurich, Zurich, Switzerland
| | - M Meuli
- Zurich Center for Fetal Therapy, University Children's Hospital Zurich, Zurich, Switzerland
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Abstract
To examine indices of behavioural and emotional problems and temperamental traits in clinically referred children and adolescents suffering from tension headache or migraine. Headache in childhood and adolescence (<18 years) has been associated with the presence of behavioural and emotional difficulties, but limited data are available on the relationship between these problems and different types of headache. Clinically referred children and adolescents ( N = 114), 6–16 years of age, suffering from primary headache according to the diagnostic criteria of the International Headache Society, 47 with tension-type headache (TH) and 67 with migraine (M), and 36 normal controls without headache (NC) were assessed using the Parent Child Behaviour Checklist (CBCL), Children's Depression Inventory (CDI), Multidimensional Anxiety Scale for Children (MASC), Conner's Parent Rating Scale (CPRS), and Emotionality–Activity–Sociability–Shyness Scale (EAS). Psychological and personality self-rating assessments were obtained also on the children's parents and siblings. Although most headache patients had scores within the normative non-pathological range, both TH and M patients had higher CBCL total, internalizing, and externalizing scores than NC ( P < 0.001), and TH patients had higher scores than M patients. TH and M had higher CDI and MASC scores than NC ( P < 0.05), with no difference between the headache groups. TH patients had higher Emotionality and Shyness scores, and lower Sociability scores than M patients. Clinically referred children and adolescents with TH and M had higher scores of behavioural and emotional symptoms, both of internalizing and externalizing type, than normal peers. The TH group had greater psychological and temperamental difficulties than the M group.
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Affiliation(s)
- L Mazzone
- Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Catania, Catania, Italy.
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Abstract
OBJECTIVE To compare the long-term self-esteem and social function outcomes of individuals with untreated and treated ADHD across childhood, adolescence, and adulthood. METHOD A systematic search of 12 databases was performed to identify peer-reviewed, primary research articles, published January 1980 to December 2011, reporting long-term self-esteem and/or social function outcomes (≥2 years; life consequences distinct from symptoms) of individuals with untreated or treated ADHD. RESULTS Overall, 127 studies reported 150 outcomes. Most outcomes were poorer in individuals with untreated ADHD versus non-ADHD controls (57% [13/23] for self-esteem; 73% [52/71] for social function). A beneficial response to treatment (pharmacological, nonpharmacological, and multimodal treatments) was reported for the majority of self-esteem (89% [8/9]) and social function (77% [17/22]) outcomes. CONCLUSION Untreated ADHD was associated with poorer long-term self-esteem and social function outcomes compared with non-ADHD controls. Treatment for ADHD was associated with improvement in outcomes; however, further long-term outcome studies are needed.
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Affiliation(s)
- V Harpin
- Sheffield Children's NHS Foundation Trust, UK
| | - L Mazzone
- I.R.C.C.S. Children's Hospital Bambino Gesù, Rome, Italy
| | | | - J Kahle
- BPS International, San Diego, CA, USA
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Moehrlen U, Ochsenbein N, Huesler M, Biro P, Scheer I, Mazzone L, Zimmermann R, Meuli M. Perinatal outcome of our first 20 cases after open fetal myelomeningocele repair at the Zurich Center for Fetal Diagnosis and Therapy. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Moehrlen U, Meuli M, Flake A, Ochsenbein N, Huesler M, Kraehenmann F, Biro P, Scheer I, Mazzone L, Zimmermann R. Update on open fetal myelomeningocele repair at the Zurich center for fetal diagnosis and therapy. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Foti F, Mazzone L, Menghini D, De Peppo L, Federico F, Postorino V, Baumgartner E, Valeri G, Petrosini L, Vicari S. Learning by observation in children with autism spectrum disorder. Psychol Med 2014; 44:2437-2447. [PMID: 24433947 DOI: 10.1017/s003329171300322x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Observing another person performing a complex action accelerates the observer's acquisition of the same action and limits the time-consuming process of learning by trial and error. Learning by observation requires specific skills such as attending, imitating and understanding contingencies. Individuals with autism spectrum disorder (ASD) exhibit deficits in these skills. METHOD The performance of 20 ASD children was compared with that of a group of typically developing (TD) children matched for chronological age (CA), IQ and gender on tasks of learning of a visuomotor sequence by observation or by trial and error. Acquiring the correct sequence involved three phases: a detection phase (DP), in which participants discovered the correct sequence and learned how to perform the task; an exercise phase (EP), in which they reproduced the sequence until performance was error free; and an automatization phase (AP), in which by repeating the error-free sequence they became accurate and speedy. RESULTS In the DP, ASD children were impaired in detecting a sequence by trial and error only when the task was proposed as first, whereas they were as efficient as TD children in detecting a sequence by observation. In the EP, ASD children were as efficient as TD children. In the AP, ASD children were impaired in automatizing the sequence. Although the positive effect of learning by observation was evident, ASD children made a high number of imitative errors, indicating marked tendencies to hyperimitate. CONCLUSIONS These findings demonstrate the imitative abilities of ASD children although the presence of imitative errors indicates an impairment in the control of imitative behaviours.
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Affiliation(s)
- F Foti
- Department of Psychology,Sapienza University of Rome,Italy
| | - L Mazzone
- Child Neuropsychiatry Unit, Department of Neuroscience,Bambino Gesù Children's Hospital,Rome,Italy
| | - D Menghini
- Child Neuropsychiatry Unit, Department of Neuroscience,Bambino Gesù Children's Hospital,Rome,Italy
| | - L De Peppo
- Child Neuropsychiatry Unit, Department of Neuroscience,Bambino Gesù Children's Hospital,Rome,Italy
| | - F Federico
- Department of Developmental and Social Psychology,Sapienza University of Rome,Italy
| | - V Postorino
- Child Neuropsychiatry Unit, Department of Neuroscience,Bambino Gesù Children's Hospital,Rome,Italy
| | - E Baumgartner
- Department of Developmental and Social Psychology,Sapienza University of Rome,Italy
| | - G Valeri
- Child Neuropsychiatry Unit, Department of Neuroscience,Bambino Gesù Children's Hospital,Rome,Italy
| | - L Petrosini
- Department of Psychology,Sapienza University of Rome,Italy
| | - S Vicari
- Child Neuropsychiatry Unit, Department of Neuroscience,Bambino Gesù Children's Hospital,Rome,Italy
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Osinga R, Mazzone L, Meuli M, Meuli-Simmen C, von Campe A. Assessment of long-term donor-site morbidity after harvesting the latissimus dorsi flap for neonatal myelomeningocele repair. J Plast Reconstr Aesthet Surg 2014; 67:1070-5. [PMID: 24865618 DOI: 10.1016/j.bjps.2014.04.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 02/27/2014] [Accepted: 04/22/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM The latissimus dorsi flap (LDF) has been employed very successfully over decades to cover large soft-tissue defects. Its donor-site morbidity has been extensively investigated in adults - but not in children - and is considered to be nonrestrictive. The aim of this long-term study was to assess donor-site morbidity with the modified Constant score more than 8 years after coverage of large myelomeningocele (MMC) defects with a reverse latissimus dorsi flap. METHODS Within the first days after birth, the reverse latissimus dorsi muscle flap was used uni- or bilaterally in three neonates to cover a large MMC defect. Bilateral shoulder function was tested more than 8 years postoperatively according to the modified Constant score. RESULTS The mean age at follow-up was 11.7 years. None of the patients experienced any pain or shoulder restrictions during normal daily activities. They all managed to position both of their arms comfortably above the head. Forward flexion was normal in all patients as was abduction and external rotation. Dorsal extension was minimally reduced on the operated side. Internal rotation was symmetric in all patients; the extent of active movement varied from excellent to poor. CONCLUSIONS Our long-term data suggest that there is no specific and significant impairment of shoulder function after using the distally pedicled reverse LDF for neonatal MMC repair.
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Affiliation(s)
- R Osinga
- Clinic of Hand, Reconstructive and Plastic Surgery, Kantonsspital Aarau, Aarau, Switzerland.
| | - L Mazzone
- Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
| | - M Meuli
- Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
| | - C Meuli-Simmen
- Clinic of Hand, Reconstructive and Plastic Surgery, Kantonsspital Aarau, Aarau, Switzerland
| | - A von Campe
- Clinic of Hand, Reconstructive and Plastic Surgery, Kantonsspital Aarau, Aarau, Switzerland
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Mekahli D, Van Straelen K, Jager K, Schaefer F, Groothoff J, Assadi MH, Landau D, Chen Y, Rabkin R, Medrano J, Segev Y, Donadio ME, Loiacono E, Peruzzi L, Amore A, Camilla R, Chiale F, Vergano L, Boido A, Conrieri M, Bianciotto M, Bosetti FM, Lastauka I, Coppo R, Laszki-SzczaChor K, Dorota PJ, Zwolinska D, Filipowski H, Rusiecki L, Sobieszczanska M, Dagan R, Davidovits M, Cleper R, Krause I, Chesnaye NC, Jager KJ, Schaefer F, Groothoff JW, Heaf JG, Topaloglu R, Merenmies J, Lewis M, Shtiza D, Maurer E, Zaicova N, Kushnirenko S, Zampetoglou A, Van Stralen KJ, Milo evski-Lomi G, Lezaic V, Radivojevic D, Kostic M, Paripovic D, Peco-Antic A, Benedyk A, Sobiak J, Resztak M, Ostalska-Nowicka D, Zachwieja J, Jarosz K, Chrzanowska M, Soltysiak J, Skowronska B, Stankiewicz W, Fichna P, Lewandowska-Stachowiak M, Silska-Dittmar M, Ostalska-Nowicka D, Zachwieja J, Lemoine S, De Souza V, Ranchin B, Cartier R, Pottel H, Dolomanova O, Hadj-Aissa A, Cochat P, Dubourg L, Hoelttae T, Van Stralen KJ, Groothoff JW, Schaefer F, Bjerre A, Jager KJ, Jobs K, Jung A, Lichosik M, Placzynska M, Tjaden LA, Noordzij M, Van Stralen KJ, Schaefer F, Groothoff JW, Jager KJ, Lazzeri E, Ronconi E, Angelotti ML, Peired AJ, Mazzinghi B, Becherucci F, Sansavini G, Sisti A, Provenzano A, Giglio S, Lasagni L, Romagnani P, Pozziani G, Sinatora F, Benetti E, Ghirardo G, Longo G, Cattelan C, Murer L, Malina M, Dusatkova P, Dusek J, Slamova Z, Cinek O, Pruhova S, Bergmann C, Seeman T, Schaefer F, Arbeiter K, Hoppe B, Jungraithmayr T, Klaus G, Pape L, Dinavahi R, Farouk M, Manamley N, Vondrak K, Vidal E, Ranieri M, Ghirardo G, Scavia G, Benetti E, Longo G, Parolin M, Murer L, Aksu N, Yavascan O, Alparslan C, Elmas CH, Saritas S, Anil AB, Kamit Can F, Anil M, Bal A, Kasap Demir B, Mutlubas Ozsan F, Van Huis M, Bonthuis M, Van Stralen KJ, Schaefer F, Jager KJ, Groothoff JW, Makieieva NI, Gramatiuk SM, Tsymbal VM, Buzhynskaya NR, Oborn H, Forinder U, Herthelius M, Westland R, Schreuder MF, Van Der Lof DF, Vermeulen A, Dekker IMJ, Bokenkamp A, Van Wijk JAE, Gramatiuk S, Makieieva NI, Tsymbal VM, Ghirardo G, Seveso M, Della Vella M, Cozzi E, Murer L, Garzotto F, Vidal E, Zanella M, Murer L, Ronco C, Prikhodina L, Chumak O, Dobrynina M, Nusken E, Von Gersdorff G, Schaller M, Rascher K, Barth C, Bach D, Weber L, Dotsch J, Roszkowska-Blaim M, Skrzypczyk P, Jander A, Tkaczyk M, Balasz-Chmielewska I, Zurowska A, Drozdz D, Pietrzyk JA, Aksenova M, Zhetlina V, Mitrofanova A, Choi Y, Cho BS, Suh JS, Abd El-Fattah MA, El-Ghoneimy DH, Elhakim IZ, El-Owaidy RH, Afifi HM, Abo-Elnaga GM, Zvenigorodska A, Tasic V, Gucev Z, Polenakovic M, Silska-Dittmar M, Zaorska K, So tysiak J, Ostalska-Nowicka D, Zachwieja J, Nowicki M, Jobs K, Jung A, Emirova K, Tolstova E, Zaytseva O, Muzurov A, Makulova A, Zverev D, Kamit Can F, Mutlbas Ozsan F, Alparslan C, Elmas CH, Saritas S, Manyas H, Kasap Demir B, Yavascan O, Aksu N, Hoste L, Braat E, De Waele L, Goemans N, Vermeersch P, Gheysens O, Levtchenko E, Pottel H, Golovachova VA, Odinets YV, Zharkova TS, Trynduk YS, Odinets YV, Kharchenko TV, Musial K, Zwolinska D, Roomizadeh P, Gheissari A, Abedini A, Mehdikhani B, Gheissari A, Rezaii Z, Merrikhi A, Madihi Y, Kelishadi R, Dryl IS, Senatorova GS, Kolybaeva TF, Muratov GR, Yavascan O, Aksu N, Alparslan C, Eliacik K, Kanik A, Saritas S, Elmas CH, Mutlubas Ozsan F, Kasap Demir B, Anil M, Bal A, Postorino V, Guzzo G, Ghiotto S, Mazzone L, Loi V, Maxia S, Roggero S, Attini R, Piga A, Postorino M, Pani A, Cabiddu G, Piccoli GB, Peco-Antic A, Kostic M, Spasojevic-Dimitrijeva B, Milosevski-Lomic G, Cvetkovic M, Kruscic D, Paripovic D. PAEDIATRIC NEPHROLOGY. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Meuli M, Moehrlen U, Flake A, Ochsenbein-Kölble N, Huesler-Charles M, Krähenmann F, Biro P, Scheer I, Mazzone L, Zimmermann R. Open Fetal Myelomeningocele Repair at the Zurich Center for Fetal Diagnosis and Therapy. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sobel LJ, Bansal R, Maia TV, Sanchez J, Mazzone L, Durkin K, Liu J, Hao X, Ivanov I, Miller A, Greenhill LL, Peterson BS. Basal ganglia surface morphology and the effects of stimulant medications in youth with attention deficit hyperactivity disorder. Am J Psychiatry 2010; 167:977-86. [PMID: 20595414 PMCID: PMC4254769 DOI: 10.1176/appi.ajp.2010.09091259] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Disturbances in the basal ganglia portions of cortico-striato-thalamo-cortical circuits likely contribute to the symptoms of attention deficit hyperactivity disorder (ADHD). The authors examined the morphologic features of the basal ganglia nuclei (caudate, putamen, and globus pallidus) in children with ADHD. METHOD A total of 104 individuals (combined-type ADHD patients: N=47; healthy comparison subjects: N=57), aged 7 to 18 years, were examined in a cross-sectional case-control study using anatomical magnetic resonance imaging. Conventional volumes and the surface morphology for the basal ganglia were measured. RESULTS Overall volumes were significantly smaller only in the putamen. Analysis of the morphological surfaces revealed significant inward deformations in each of the three nuclei, localized primarily in portions of these nuclei that are components of limbic, associative, and sensorimotor pathways in the cortico-striato-thalamo-cortical circuits in which these nuclei reside. The more prominent these inward deformations were in the patient group, the more severe the ADHD symptoms. Surface analyses also demonstrated significant outward deformations of all basal ganglia nuclei in the ADHD children treated with stimulants compared with those ADHD youth who were untreated. These stimulant-associated enlargements were in locations similar to the reduced volumes detected in the ADHD group relative to the comparison group. The outward deformations associated with stimulant medications attenuated the statistical effects of the primary group comparisons. CONCLUSIONS These findings potentially represent evidence of anatomical dysregulation in the circuitry of the basal ganglia in children with ADHD and suggest that stimulants may normalize morphological features of the basal ganglia in children with the disorder.
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Affiliation(s)
- LJ Sobel
- Department of Psychiatry, New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY 10032,University of Chicago-Pritzker School of Medicine, Chicago, IL 60637
| | - R Bansal
- Department of Psychiatry, New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - TV Maia
- Department of Psychiatry, New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - J Sanchez
- Department of Psychiatry, New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - L Mazzone
- Department of Psychiatry, New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - K Durkin
- Department of Psychiatry, New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - J Liu
- Department of Psychiatry, New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | | | - I Ivanov
- Mount Sinai School of Medicine, New York, NY 10029
| | - A Miller
- Department of Psychiatry, New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - LL Greenhill
- Department of Psychiatry, New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - BS Peterson
- Department of Psychiatry, New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY 10032
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Abstract
PURPOSE Aim of the study was to provide an age-adapted rehabilitation protocol for flexor tendon repairs of children and to evaluate a patient series accordingly. METHODS A modified Kessler's technique was used to repair 49 flexor tendon injuries in 39 children. All children had immediate postoperative mobilization according to the protocol that provides specific guidelines for preschoolers, children and teenagers. Range of motion was monitored and the final results were evaluated retrospectively. RESULTS All children could be treated successfully according to the protocol with no occurrence of secondary tendon ruptures. Forty finger injuries were evaluated according to the Strickland classification, resulting in a median total active motion of 92.6 % with 29 (72.5 %) excellent results, 8 (20 %) good results, 3 (7.5 %) fair results and no poor result. All 7 thumbs had an excellent result according to the Buck-Gramcko score. There was no significant difference in outcomes between the three age groups. CONCLUSIONS The rehabilitation protocol provided in this study allows an age-adapted early mobilization of children's hands after flexor tendon injuries. It respects age-specific limitations in rehabilitation and takes a child's superior healing capacity compared to adults into account. The good results and the very low complication rate observed in the present series suggest that the extra effort of early mobilization may be justified.
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Affiliation(s)
- U Moehrlen
- Department of Surgery, University Children's Hospital Zurich, Zurich, Switzerland
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Lombardo SA, Leanza G, Meli C, Lombardo ME, Mazzone L, Vincenti I, Cioni M. Maternal exposure to the antiepileptic drug vigabatrin affects postnatal development in the rat. Neurol Sci 2005; 26:89-94. [PMID: 15995825 DOI: 10.1007/s10072-005-0441-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2005] [Accepted: 04/14/2005] [Indexed: 11/24/2022]
Abstract
The objective was to investigate, in the rat, the effects of maternal exposure to vigabatrin (VGB) on the postnatal motor-cognitive behaviour of the offspring. We used an experimental evaluator-blind, placebo-controlled study in the rat. Ten pregnant rats were divided into five groups and treated with different doses of VGB (250, 500, 750, 1000 mg/kg/day) or placebo from gestation day (GD) 6 to GD10. After delivery, 56 pups (40 pups prenatally exposed to VGB and 16 pups exposed to placebo) were evaluated for motor-cognitive behaviour throughout postpartum day 40. At the end of testing sessions the animals were sacrificed and brain tissues processed for biochemical analysis of GABA levels. Body weight of pups and young rats whose mothers were treated with a dose of 750 mg/kg/day were significantly lower both at birth and during the whole postnatal life with respect to the control groups. Young rats of this group exhibited impaired performance in both the open-field and water maze tasks. Brain GABA contents were dramatically increased in this group of rats. No other significant nutritional, biochemical or behavioural changes were observed after treatments with doses of VGB lower than 750 mg/kg/day. The exposure to a dose of 1000 mg/kg caused abortion. Maternal exposure to VGB at relatively high doses (750 mg/kg/day) is likely to cause some important changes of the nutritional status during the pre- and postnatal life. Thus, the biochemical and cognitive abnormalities observed in this study could be related to some disturbances of brain development induced by malnutrition and/or to a disturbance of neuronal programming of the gabaergic system.
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Affiliation(s)
- S A Lombardo
- Department of Experimental and Clinical Pharmacology, Chair of Neuropsychopharmacology, School of Medicine, University of Catania, Viale A. Doria 6, I-95125 Catania, Italy
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Cerulli C, Sciarra A, Mazzone L, Autran Gomez AM, Salciccia S, Di Silverio F. Primary Carcinoid Tumor in a Horseshoe Kidney. Urologia 2005. [DOI: 10.1177/039156030507200206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report on a rare case of primary carcinoid tumor in a horseshoe kidney. A 56-year-old male was referred at our clinic with a history of urinary tract stones. A CT scan revealed a horseshoe kidney with a large mass in the lower pole of the right kidney. The patient was submitted to a partial right nephrectomy with resection of the lower half of the right kidney and isthmectomy The histological and immunohistochemical findings were compatible with a diagnosis of primary carcinoid tumor. After 24 months the patient is still alive without evidence of recurrence or progression.
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Affiliation(s)
- C. Cerulli
- Dipartimento di Urologia, Università La Sapienza, Roma
| | - A. Sciarra
- Dipartimento di Urologia, Università La Sapienza, Roma
| | - L. Mazzone
- Dipartimento di Urologia, Università La Sapienza, Roma
| | | | - S. Salciccia
- Dipartimento di Urologia, Università La Sapienza, Roma
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Mazzone L, Mugno D, Morales G, Genitori D'Arrigo V, Ruta L, Bianchini R. [Sport activity in children and adolescents: temperament and emotional traits]. Minerva Pediatr 2004; 56:109-13. [PMID: 15249920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
AIM Aim of this study is to evaluate anxiety and temperament characteristics in developmental age subjects who practised agonistic sport (individual or team sports) in comparison with a sample group of subjects who practice no agonistic sports. METHODS Sixty subjects aged from 10 to 16 years were enrolled in the study and divided into 3 groups: 20 subjects practised individual agonistic sport (Group A), 20 subjects practised team agonistic sports (Group B) and 20 subjects who practised non agonistic sport as control group, (Group C). The following tests were used: multidimensional anxiety scale for children (MASC) to evaluate anxiety, EAS scale (Buss e Plomin) to evaluate temperament (emotionability, activity, sociability and shyness for younger children). RESULTS MASC scale scores underline generalized anxiety with higher significantly score in subjects who practised agonistic sports (Group A and B) compared with Group C. Anxiety symptoms were more evident in subjects who practised individual discipline compared with those who practised team sports. EAS scale indicated that temperament of subjects who practised agonistic sport was characterised by a considerable aptitude for sociability with low emotionability/activity levels in comparison to control group. CONCLUSION None of the 3 groups showed a psychopathologic profile.
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Affiliation(s)
- L Mazzone
- Divisione di Neurologia e Psichiatria Pediatrica, Dipartimento di Pediatria, Università degli Studi di Catania, Catania, Italy.
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Mazzone D, Nicolosi A, Aliberti C, Mazzone L, Caruso-Nicoletti M. [Psychological findings in children with short stature]. Minerva Pediatr 2003; 55:261-6. [PMID: 12900711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
AIM The aim of this study is to evaluate the psychological findings in patients with short stature. METHODS We studied 19 subjects, 13 males and 6 females, with age range 7-14 years. We evaluated heigth, growth velocity, bone age, target height and growth hormone secretion after provocative stimuli. Psychological evaluation included: Kovacs Scale, Children's Depression Inventory (CDI), Anxiety Scale (Busnelli-Dall'Aglio-Farina); drawing of the human figure (Goodenough Test); Raven Test for neuropsychological performances (P.M. 38 and 47). Statistical analysis was performed using Mann-Whitney U-test. RESULTS We diagnosed familial short stature (FSS) in 7 patients and growth hormone deficit (GHD) in 12. No statistical difference was found in the anxiety and depression tests, although the score was higher in GHD patients. The human figure drawing and the interview revealed low self-esteem, sense of inadequacy, dependence from parents, social inhibition in all patients. These characteristics were more evident in patients with GHD. Neuropsycho-logical evaluation by Raven test showed normal score in all patients, however subjects with FSS exhibited a higher score than with GHD (p<0.05). CONCLUSIONS Our data suggest a negative influence of short stature on the affective field of children with short stature; GHD patients exhibited lower neuropsychological performances and more psychological problems than patients with FSS.
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Affiliation(s)
- D Mazzone
- Servizio di Neuropsichiatria Infantile, Dipartimento di Pediatria, Azienda Policlinico Università degli Studi di Catania, Catania, Italy.
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Allampallam K, Dutt D, Nair C, Shetty V, Mundle S, Lisak L, Andrews C, Ahmed B, Mazzone L, Zorat F, Borok R, Muzammil M, Gundroo A, Ansaarie I, Raza A. The clinical and biologic significance of abnormal lipid profiles in patients with myelodysplastic syndromes. J Hematother Stem Cell Res 2000; 9:247-55. [PMID: 10813538 DOI: 10.1089/152581600319469] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Serum lipid profiles were obtained in 108 patients with myelodysplastic syndrome (MDS) and compared to 28 healthy volunteers. Serum cholesterol and low-density and high-density lipoproteins (LDL and HDL) were found to be significantly lower in MDS patients than in normals (p = 0.0001, 0.0038 and 0.037, respectively). This difference was significant for all MDS categories. Serum cholesterol and HDL were negatively related to biopsy cellularity (p = 0.001 and 0.0001, respectively), and serum triglycerides were negatively related to labeling index (p = 0.0003). No differences were noted in the lipid profiles of MDS patients with normal versus abnormal karyotypes. However, low-risk MDS patients with abnormal karyotypes had significantly lower triglyceride levels compared with the high-risk patients (p = 0.027), as did low-risk patients with normal cytogenetics (p = 0.015). Serum HDL levels were significantly higher for the low-risk group with normal cytogenetics as well (p = 0.003). We conclude that serum cholesterol, LDL, and HDL are significantly reduced in MDS patients, probably indicating excessive intracellular lipid biosynthesis in the expanding clone. These relatively simple measurements could serve as important prognostic markers and reliable indicators of disease activity in individual patients. Prospective studies to determine their utility as independent variables that guide the need for active therapeutic intervention are warranted.
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Affiliation(s)
- K Allampallam
- Rush Cancer Institute, Rush-Presbyterian St. Luke's Medical Center, Chicago, IL 60612-3515, USA
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Smilari P, Incorpora G, Sciacca P, Marletta M, Saporito A, Mazzone L, Romeo DM, Cilauro S, Romeo MG. Vein of Galen aneurysmal malformation. Different clinical expressiveness. Three case reports. Minerva Pediatr 2000; 52:55-62. [PMID: 10829593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The vein of Galen aneurysmal malformation (VGAM) is a rare cerebro-vascular disorder in neonates. It is characterized by an abnormal direct communication between one or several cerebral arteries and the vein of Galen. It may appear in the neonatal period or afterwards. Three cases of patients affected by VGAM with different clinical expression are presented. Two of them were treated successfully with endovascular embolization. It was not possible to provide the same treatment to the third patient for an intractable congestive heart failure already existing when VGAM was diagnosed.
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Affiliation(s)
- P Smilari
- Department of Pediatrics, Catania University School of Medicine, Azienda Policlinico
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Ireland EF, Mazzone L. Surviving the bite of health care reform: the future for dental benefits. Med Interface 1994; 7:74-8. [PMID: 10137580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Dental benefits are not in the eye of the storm over cost and availability of health benefits. However, actions to reform health care on the state and federal level will affect the dental benefit market. Rather than having a direct effect, the potential is for health care reform to inadvertently devastate the dental benefits market and reduce the overall oral health of the nation.
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Affiliation(s)
- E F Ireland
- National Association of Prepaid Dental Plans, Dallas, TX 75244
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